**Abstract**

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by a wide range of manifestations from mild to life-threatening. Prognosis has markedly improved in the last decades due to earlier diagnosis, prevention of comorbidities, and the use of more intensive treatment regimens. However, the high rates of morbidity, despite treatment, reflect the presence of numerous unmet medical needs in patients with SLE, calling for new, treat-to-target strategies. To date, only two biological agents, belimumab and recently anifrolumab, have been approved in patients with SLE with several others showing promising results. In this review, we critically review the data, with emphasis on the approved biologics.

**Keywords:** systemic lupus erythematosus, pathogenesis, biologic therapies, targeted therapies, B-cells
